Re: Medical conditions and severe fat restriction, not caloric restriction, cause gall stones
- From: "Evelyn" <evelyn.ruut@xxxxxxxxx>
- Date: Wed, 11 Nov 2009 21:07:23 -0500
"Susan" <susan@xxxxxxxxxxxx> wrote in message news:7m16s5F3dubrfU1@xxxxxxxxxxxxxxxxxxxxx
It appears that whatever medical condition underlies extreme obesity, combined with the terrible fat deficiencies and crap contents of bad diet plans cause gall stones, NOT caloric restriction itself.
Dig Liver Dis. 2003 Jul;35 Suppl 3:S12-6.
Gallbladder motility in obesity, diabetes mellitus and coeliac disease.
Fraquelli M, Pagliarulo M, Colucci A, Paggi S, Conte D.
University of Milan, Milan, Italy.
We reviewed data on gallbladder motility in obesity, diabetes and coeliac disease. In obesity, a condition characterised by increased risk of gallstone(s), decreased gallbladder motility has heterogeneously been reported as a consequence of the different type of meals used to induce gallbladder contraction, characteristics of the population studied, technique used, and proportion of patients with hyperinsulinaemia. Moreover, recent studies have evaluated the effect of dietary restriction on gallbladder motility in obese patients. A two- to three-fold increase in the risk of cholesterol gallstone(s) has been reported in diabetic patients, mainly in relation to obesity and hypertriglyceridaemia.
******Furthermore, decreased gallbladder motility has been described and attributed to other factors, including underlying autonomic neuropathy, reduced gallbladder sensitivity to cholecystokinin and/or reduced number of cholecystokinin receptors on the gallbladder wall. Impaired gallbladder motility has been reported also in patients with coeliac disease in relation to reduced secretion of enteric hormones and/or decreased gallbladder sensitivity to them. In particular, untreated coeliacs, when compared to controls, showed low postprandial cholecystokinin and increased fasting somatostatin levels. Interestingly, the correlation between fasting somatostatin levels and gallbladder size has clearly been confirmed in patients affected by somatostatinoma or treated with somatostatin or its analogues. ************
THIS ADDRESSES CAUSES IN CONDITIONS THAT LEAD TO GALL STONE FORMATION:
Gallbladder motility can be affected by various clinical conditions, such as obesity, diabetes mellitus and coeliac disease.
Aliment Pharmacol Ther 2000 May;14 Suppl 2:51-3
Review: low caloric intake and gall-bladder motor function.
Festi D; Colecchia A; Larocca A; Villanova N; Mazzella G; Petroni ML; Romano F; Roda E.
Department of Medicine and Aging, University G. d'Annunzio, St Annunziata Hospital, Chieti, Italy.
Cholelithiasis is the primary _expression of obesity in the hepatobiliary system. In obese subjects the risk of developing gallstones is increased due to a higher cholesterol saturation of gall-bladder bile. During weight reduction with very low calorie diets (VLCD) the incidence of gallstones increases, but the mechanism for gallstone formation is not completely understood and several pathogenetic mechanisms have been suggested: increased saturation of bile, increased gall-bladder secretion of mucin and calcium, increased presence of prostaglandins and arachidonic acid. Alterations in gall-bladder motility may contribute to gallstone formation, but few studies have addressed the issue of gall-bladder motility during rapid weight loss and its possible role in gallstone formation. VLCD have been associated with a gall-bladder stasis, as a consequence of reduced gall-bladder stimulation by low fat content of the diets. A threshold quantity of fat (10 g) has been documented to obtain efficient gall-bladder emptying. Ursodeoxycholic acid administered during VLCD seems to have a protective role in developing a biliary cholesterol crystals.
THIS SAYS THAT ADDING FAT TO A VERY LOW CALORIE DIET COULD PREVENT GALL STONES:
******Gall-bladder emptying was lower in response to low fat meals with respect to relative higher fat meals, before as well as during the VLCD. This may account the possibility of an adaptative response of the gall-bladder motility to a given diet regimen. Adequate fat content of the VLCD may prevent gallstone formation, maintaining adequate gall-bladder motility and may be more economic and physiologically acceptable than administration of a pharmacological agent.******
Int J Obes Relat Metab Disord 1998 Jun;22(6):592-600
Gallbladder motility and gallstone formation in obese patients following very low calorie diets. Use it (fat) to lose it (well).
Festi D; Colecchia A; Orsini M; Sangermano A; Sottili S; Simoni P; Mazzella G; Villanova N; Bazzoli F; Lapenna D; Petroni ML; Pavesi S; Neri M; Roda E.
Department of Medicine and Aging, University G D'Annunzio Chieti, Italy.
Dieting obese subjects are at risk of developing gallstones. A gallbladder motor dysfunction could have a pathogenetic role. The principal aim of this study was to evaluate the long term effects of two very low calorie diets differing in fat content on gallbladder emptying and gallstone formation in obese subjects. DESIGN AND SUBJECTS: Gallbladder emptying in response to meals (breakfast, lunch and dinner) in two different diet regimens (3.0 vs 12.2 g of fat/d) was evaluated by ultrasonography in 32 gallstone-free obese patients on different days, before and during (at 45 d intervals) one or two 6-month weight reduction diets (for the first three months: 2.24 MJ (535.2 kcal), 3.0 g fat/d vs 2.415 MJ (577.0 kcal), 12.2 g fat/d; for the second three months, the same low calorie diet of 4.194 MJ (1002 kcal)/d for both groups). In 10 subjects, bile analysis was also performed. RESULTS: Twenty-two (69%) subjects concluded the study, eleven in each group, and a significant weight loss was achieved by all subjects. Gallstones (asymptomatic) developed in 6/11 (54.5%) (P < 0.01) of subjects following the lower fat diet, but in none with the higher fat regimen. In the dieters during the first three months (very low calorie phase) the higher fat meals always induced a significantly greater gallbladder emptying than the lower fat meals. The cholesterol saturation index initially increased significantly and then decreased, without difference between the two groups.
THIS CONCLUDES THAT THE FAT RESTRICTION WAS AT FAULT:
********CONCLUSION: In the obese during rapid weight loss from a very low calorie diet, a relatively high fat intake could prevent gallstone formation, probably by maintaining an adequate gallbladder emptying, which could counterbalance lithogenic mechanisms acting during weight loss.*****************
Int J Obes Relat Metab Disord. 1995 Aug;19(8):593-5
Gallstone formation in obese women treated by a low-calorie diet.
Spirt BA, Graves LW, Weinstock R, Bartlett SJ, Wadden TA.
State University of New York Health Science Center (Syracuse, NY), Department of Radiology, USA.
This study assessed the incidence of gallstone formation in 47 obese women who consumed a low-calorie diet (LCD) for the first 16 weeks of a 26-week weight loss program. The LCD consisted of four daily servings of a liquid diet combined with an evening meal of a pre-packaged dinner entree and provided approximately 925 kcal/d. Six of the 47 patients (12.8%) displayed gallstones at week 17, as determined by sonography. Five patients were asymptomatic when followed for up to 48 weeks. The sixth, however, reported severe abdominal pain 30 weeks after beginning treatment and required a cholecystectomy. Patients who developed gallstones, as compared with those who did not, had significantly higher baseline triglyceride and total cholesterol levels and had a significantly greater rate of weight loss.
THIS SUGGESTS OTHER CAUSES:
********Results of this study indicate that an increased risk of gallstones is not limited to very-low-calorie diets and that the incidence of this complication should be assessed in persons who consume popular over-the-counter meal replacement plans.*********
Thanks for looking this up and clarifying.
"Even as a mother protects with her life her only child, So with a boundless heart let one cherish all living beings." --Sutta Nipata 1.8
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